There are several different types of scoliosis that affect children. By far, the most common type of scoliosis is "idiopathic," which means the exact cause is not known. Idiopathic scoliosis occurs in toddlers and young children, but the majority of cases occur from age 10 to the time a child is fully grown.

What is the difference between idiopathic scoliosis and other types of scoliosis?

Idiopathic scoliosis. The term "idiopathic" means unknown cause. Although we do not know for sure what causes the majority of scoliosis cases (80% to 85%), we do know it tends to run in families. Scoliosis is not a disease that is caught from someone else, like a cold. There is nothing you could have done to prevent it.

Congenital scoliosis. The term "congenital" means that you are born with the condition. Congenital scoliosis starts as the spine forms before birth. Part of one vertebra (or more) does not form completely, or the vertebrae do not separate properly. This type of scoliosis can be associated with other health issues, as well as heart and kidney problems.

Neuromuscular scoliosis. Any medical condition that affects the nerves and muscles can lead to scoliosis. This is most commonly due to muscle imbalance and/or weakness. Common neuromuscular conditions that can lead to scoliosis include cerebral palsy, muscular dystrophy, and spinal cord injury.

(Left) An adolescent with thoracic idiopathic scoliosis on the right side. (Center) Her rib prominence is more obvious when bending forward. (Right) This x-ray of her spine clearly shows the right thoracic curve.

Courtesy of Texas Scottish Rite Hospital for Children.

How serious is adolescent scoliosis?

Adolescent scoliosis is not life threatening, and most curves do not cause serious problems. If a curve is large, however, it may affect growth.

If the curve gets really large, it can cause heart and lung problems. A very severe curve can also compress nerve roots or the spinal cord, which can result in paralysis. This is extremely rare. Proper treatment will prevent the curve from progressing to such a severe degree.

Does scoliosis cause back pain?

Adolescent scoliosis should not cause back pain, although larger curves may cause occasional discomfort.

If the back pain is severe or is associated with weakness of the limbs or numbness, call your doctor.

Can scoliosis curves get better on their own?

Idiopathic scoliosis curves do not straighten out on their own. Many children have slight curves that do not need treatment. In these cases, the children grow up to lead normal lives - but their small curves never go away.

If larger curves are not treated, the best you can hope for is that they will not get worse. This depends on how much growing your child has left to do. Curves in children who are almost full-grown may stop getting worse. If your child's spine is still growing, it is more likely that the curves will worsen.

What can I do to prevent my scoliosis from getting worse?

The only treatments that have been shown to affect idiopathic scoliosis are bracing and surgery. There is no evidence in the current medical literature that physical therapy, electrical stimulation, chiropractic care, or other options have any impact on scoliosis curves.

Is it safe for my child to exercise and participate in sports?

Children with idiopathic scoliosis can participate in any sport as long as they have no backache associated with participation. It is always a good idea for children to stay physically fit with exercise.

Will my child be able to live a normal life?

Yes. People who have curves that do not require surgery are able to participate in the same activities and sports as people without scoliosis. There are rarely restrictions on any of their activities.

The same usually applies to people who have had surgery for scoliosis. They can have the same jobs as people who have not had scoliosis surgery. They can usually do the same sports as before surgery. They should, however, contact their doctors before starting new activities (jobs or sports) to make sure they have no specific restrictions.

Does scoliosis run in families?

Yes, approximately 30% of adolescent idiopathic scoliosis (AIS) patients have a family history of scoliosis. There is currently a lot of research being done to investigate this genetic or hereditary link.

If I have scoliosis, will my children have it?

According to recent research, about one in three children whose parents have scoliosis will develop scoliosis. Scoliosis is considered a partially genetic condition. Doctors do not know exactly what gene can cause it.

A genetic test for idiopathic scoliosis does exist, but it is specific to certain ethnicities. This test is used to predict whether or not a patient's scoliosis is likely to get worse and need a brace or surgery. Doctors do not yet know if the test can be used to predict the likelihood of passing on scoliosis to one's children.

Does my child's bad posture cause the scoliosis?

No, bad posture does not cause scoliosis. The scoliosis may be the reason for your child's bad posture, especially if he or she tends to lean to one side.

Does a leg length difference cause or worsen the curve?

Leg length difference does not cause scoliosis. A large leg length difference can, however, make idiopathic scoliosis appear worse. In this uncommon circumstance, a shoe lift may be recommended.

Shoe lifts are also helpful when taking x-rays to correct any trunk imbalance that might be related to a difference in leg lengths.

Do sports activities or heavy book bags cause scoliosis?

Sports activities or heavy backpacks do not cause scoliosis or make a curve worse. Heavy backpacks can be related to back pain, however. If back pain is present, it is advisable to lighten the load. Kids should carry lighter backpacks with the straps over both shoulders.

Is scoliosis related to an injury?

Idiopathic scoliosis is not caused by an injury or trauma.

Could I have prevented it?

Because the causes of idiopathic scoliosis are not known exactly, it is hard to determine how to prevent it. If the causes are genetic, then there really is not much to do once a baby is conceived.

Scoliosis is often first detected during a regular check-up with the pediatrician.

How early should children be screened for scoliosis?

Children can be screened at any age, although idiopathic scoliosis is more commonly discovered during a child's growth spurt (10 to 15 years old). The Scoliosis Research Society recommends that girls be screened twice, at 10 and 12 years of age (grades 5 and 7), and boys once at 12 or 13 years of age (grades 8 or 9). A great deal of controversy exists as to the benefits of school screening.

Do siblings of children with scoliosis need to be checked?

Because scoliosis tends to run in families, it is good to have siblings checked at their yearly physical examinations, especially during their growth spurts (10 to 15 years old).

Early detection is important and parents can help. Look at your child's back with a bathing suit on. If you see one shoulder appearing higher than the other, or one side of the ribcage sticking out more than the other side, call your pediatrician.

When should the child of scoliotic parents be examined?

Children of scoliotic parents should be checked at their yearly physical examinations, especially during their growth spurts (10 to 15 years old).

Why didn't we notice it sooner?

In many cases, curves do not appear until the early teenage years. Small curves often go unnoticed until a child hits a growth spurt during puberty. Because scoliosis is rarely painful, children and their parents may not discover it until there are more obvious signs.

In addition, adolescents tend to be modest. Many girls are self-conscious and tend to wear baggy clothing. It isn't until they wear more form-fitting clothes (bathing suits, t-shirts) that the curves are apparent.

Also, adolescents may not see their pediatricians on a regular basis.

Why didn't our pediatrician see it sooner?

Scoliosis curves can get worse very fast, especially during pre-adolescence. Your pediatrician may not have seen your child during this time of growth.

What scoliosis research is currently being conducted?

At present, the main research focus in idiopathic scoliosis is investigation into the cause of the condition.

There are many factors that may contribute to curving of the spine. The main factors currently being studied are genetics (heredity), soft tissue problems (bone, muscle, ligaments, and disks), vertebral growth problems, and central nervous system disorders.

Are children born with idiopathic scoliosis?

Children with true adolescent idiopathic scoliosis may have been born with the genetic markers that cause scoliosis. The genes that these markers are on are not known exactly, and researchers are working on finding them.

Is there genetic testing?

Yes, there is a genetic test to help determine whether a curve will get worse. However, the test is currently only for a select group of children. These are Caucasian girls between the ages of 9 and 13, with curves measuring 10 to 25 degrees. Researchers are working on improving the test to include all ethnic groups and all ages of children.

Reviewed by members of the Pediatric Orthopaedic Society of North America and the Scoliosis Research Society

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS "Find an Orthopaedist" program on this website.